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Generic Name: collagenase clostridium histolyticum (KOL a JEN ase klos TRID ee um HIS toe LIT ik um)
Brand Names: Xiaflex
Xiaflex (collagenase clostridium histolyticum) is used to treat Dupuytren's contracture is adults. Includes Xiaflex side effects, interactions and indications.
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Drug Information:
Xiaflex (collagenase clostridium histolyticum) is made from a mixture of proteins derived from a certain bacteria. Xiaflex is used to treat Dupuytren's contracture in adults. This condition causes an abnormal thickening of the tissue in the palm of the hand. This condition may get worse over time and form a "cord" in your palm, causing a permanent bend in your finger. Xiaflex is also used to treat a related condition called Peyronie's disease in adult men. This condition causes scar tissue or "plaque" to develop under the skin of the penis, resulting in an abnormal curving of the penis during erection. Learn more

Xiaflex Side Effects

Xiaflex Side Effects

Note: This document contains side effect information about collagenase clostridium histolyticum. Some of the dosage forms listed on this page may not apply to the brand name Xiaflex.

In Summary

Common side effects of Xiaflex include: bleeding at injection site, pruritus, bruise, and ecchymoses. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to collagenase clostridium histolyticum: injection powder for solution


Injection route (Powder for Solution)

Corporal rupture (penile fracture) and severe penile hematoma have been reported with use. Promptly evaluate signs or symptoms that reflect serious penile injury, as surgical intervention may be required. Collagenase clostridium histolyticum is only available through a restricted program called the Xiaflex REMS program.

Along with its needed effects, collagenase clostridium histolyticum (the active ingredient contained in Xiaflex) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking collagenase clostridium histolyticum:

More common—Dupuytren's contracture

  • Bruising or bleeding at the injection site
  • swelling of the hands
  • tearing of the skin

More common—Peyronie's disease

  • Itching, pain, redness, swelling, or bruise of the penis
  • popping sound or sensation in an erect penis

Less common—Peyronie's disease

  • Decreased interest in sexual intercourse
  • inability to have or keep an erection
  • loss in sexual ability, desire, drive, or performance
  • painful sexual intercourse

Incidence not known—Dupuytren's contracture

  • Bone pain
  • lower back or side pain
  • painful, swollen joints

Some side effects of collagenase clostridium histolyticum may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common—Dupuytren's contracture

  • Blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, lumps, numbness, rash, scarring, stinging, tingling, or ulceration at the injection site
  • bruise
  • flushing, redness of the skin or unusually warm skin at the injection site
  • itching, pain, swelling, or tenderness at the injection site
  • swollen, painful, or tender lymph glands in the neck or armpit

For Healthcare Professionals

Applies to collagenase clostridium histolyticum: injectable powder for injection


Very common (10% or more): Pain in extremity (35%), arthralgia (11%)

Common (1% to 10%): Shoulder pain

Uncommon (0.1% to 1%): Axillary mass, chest wall pain, groin pain, joint crepitation, joint stiffness, limb discomfort, muscle spasms, muscular weakness, musculoskeletal stiffness, neck pain, tendon rupture


Very common (10% or more): Injection site hemorrhage (38%), injection site reaction (erythema, inflammation, irritation, pain, warmth) (35%), injection site swelling and edema (24%), pruritus (15%), blood blister (13%)

Common (1% to 10%): Ecchymosis, hyperhidrosis, rash, skin laceration

Uncommon (0.1% to 1%): Eczema, swelling face, pain of skin, skin exfoliation, skin lesion, scab, skin discoloration, skin tightness


Very common (10% or more): Peripheral edema (most cases were swelling of the injected hand) (73%)

Frequency not reported: Vasovagal syncope (after finger extension procedures)


Very common (10% or more): Contusion (any body system) and ecchymosis (70%), tenderness (24%)

Common (1% to 10%): Axillary pain

Uncommon (0.1% to 1%): Breast tenderness, hypertrophy breast


Common (1% to 10%): Lymphadenopathy, lymph node pain

Uncommon (0.1% to 1%): Thrombocytopenia


Common (1% to 10%): Nausea

Uncommon (0.1% to 1%): Diarrhea, vomiting, abdominal pain upper


Patients with Peyronie's disease:

Very common (10% or more): Penile hematoma (65.5%), penile swelling (55%), penile pain (45.4%), penile ecchymoses (14.5%), a popping noise or popping sensation in the penis, sometimes described as "snapping" or "cracking", and sometimes accompanied by detumescence, hematoma, and/or pain (13.2%)

Common (1% to 10%): blood blister (4.5%), penile blister (3.3%), genital pruritus (3.1%), painful erection (2.9%), erectile dysfunction (1.8%), procedural pain (1.6%), injection site vesicles (1.3%), localized edema (1.3%), dyspareunia (1.1%), injection site pruritus (1.1%), nodule (1.1%), suprapubic pain (1.1%)

Uncommon (0.1% to 1%): Corporal rupture (penile fracture) (0.5%)


Very common (10% or more): Lymphadenopathy (13%)

Common (1% to 10%): Lymph node pain

Uncommon (0.1% to 1%): Thrombocytopenia


Uncommon (0.1% to 1%): Hypersensitivity


Uncommon (0.1% to 1%): Injection site cellulitis, lymphangitis

Nervous system

Common (1% to 10%): Burning sensation, dizziness, headache, hypoesthesia, paresthesia

Uncommon (0.1% to 1%): Disorientation, agitation, insomnia, irritability,



Uncommon (0.1% to 1%): Eyelid edema


Uncommon (0.1% to 1%): Dyspnea, hyperventilation

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Xiaflex